Field Medical Director – Internal Medicine, Emergency Medicine, Cardiology

Job not on LinkedIn

🕒 March 20

🇺🇸 United States – Remote

💵 $96 - $100 / hour

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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Evolent

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

⚕️ Healthcare Insurance

☁️ SaaS

Healthcare Insurance • Healthcare • SaaS

Evolent is a healthcare company focused on improving care outcomes through its comprehensive management solutions across multiple medical specialties. They aim to enhance the patient care journey by offering coordinated services in areas like oncology, cardiology, musculoskeletal disorders, and primary care, while ensuring high-quality treatment pathways and cost management. Evolent believes every person deserves quality care, striving to align treatment guidelines and innovative approaches to meet patient needs effectively.

📋 Description

• Serve as the specialty-match reviewer for diagnostic cardiology cases • Review all cases in which clinical determinations cannot be made by Initial Clinical Reviewers • Provide clear, evidence-based clinical rationale for standard and expedited appeals • Conduct peer-to-peer discussions with requesting physicians or ordering providers • Utilize medical and clinical review guidelines and parameters to ensure consistency in physician review processes • Assist and act as a clinical resource to Field Medical Directors and Initial Clinical Reviewers • Ensure all communications with medical office staff and/or physician providers are documented accurately • Participate in ongoing training initiatives • Assist the Senior Medical Director with research activities and questions • Review appeal cases and/or attend hearings to support utilization management determinations • Function as Medical Director for select health plans or regions as requested

🎯 Requirements

• DO, MD, or MBBS degree from an accredited institution • Current Board Certification in Emergency Medicine or Internal Medicine by an American Certifying Board • Current, unrestricted medical license in one or more U.S. states • Current Unrestricted Medical License in Home State • Demonstrated strong knowledge of diagnostic cardiology, including evaluation and management of cardiovascular conditions • Five (5) years of post-residency clinical experience • Strong verbal and written communication skills, including the ability to effectively engage in peer-to-peer discussions with treating providers • Proficient computer skills and experience working with clinical review and documentation systems • Active clinical practice experience within the past 18 months • Familiarity with utilization management principles and procedures within managed care organizations

🏖️ Benefits

• Health insurance benefits • Comprehensive benefits to qualifying employees